Your Innovative
Pharmacy Benefit
Expert

 

 

 

Crumdale Partners provides pharmacy benefit management through our PBM division. We deliver pharmacy savings with flexible and strategic pharmacy benefits.

01 HOW WE HELP

Customized, Competitive Pharmacy Benefits

Crumdale Partners is an innovative pharmacy solutions provider for all constituents of the pharmacy supply chain. We offer consulting services, mid-market coalition contracts, specialty management programs, and Rx-only stop-loss coverage. Our comprehensive PBM solutions continually cut costs for employer groups.

  • Over 30 Years of Experience
  • Innovative Specialty Rx Solutions
  • Plan Flexibility
  • Ongoing Guidance & Support

    1000+

    CLIENTS

    50%

    PLAN SAVINGS THROUGH SPECIALTY MANAGEMENT PROGRAMS

    25%

    AVERAGE FIRST-YEAR SAVINGS

    100%

    CONTRACT
    TRANSPARENCY

    15% - 35%

    FIRST-YEAR
    SAVINGS

    3%

    GROWTH TREND
    YEAR-OVER-YEAR

    Built With Transparency for Brokers & TPAS

    Our independent, transparent and vendor-agnostic approach ensures that clients are matched with solutions that create the most value while minimizing disruption. Our PBM solutions are built for the broker and TPA market to deliver customized and competitive solutions for:

    • RFP Consulting Services
    • Contract/Pricing Validation
    • Coalition-Level, Signature-Ready Contracts with Market-Leading Pricing
    • Specialty Drug Management
    • Rx-Only Stop-Loss
    • Rebate Procurement

      integrated

      02 WHAT YOU NEED

      Clear PBM Contracts With Cost Containment Built In

      Crumdale’s in-house pharmacy division and group purchasing coalition offers custom and specialty Rx solutions that continuously control costs for clients. We deliver best-in-class PBM contracts and pricing with 100% transparency and advanced solutions for savings.

      • 1st-year pharmacy savings of ~15% – 33%
      • In-house PBM experts to negotiate best-in-class terms & pricing
      • Transparent prescription management & pricing

      Proactive Management With Predictive Analytics

      Our proactive pharmacy benefits management uses predictive analytics to provide trend and cost management. We also negotiate leading contracts to benefit any group size and help clients navigate the pharmacy ecosystem for improved clinical insight that delivers better health and financial solutions.

      • Transparency & expert insight into Rx spend drivers
      • Continuous high-cost claims management & high-cost drug support
      • Integrated PBM with specialty management programs

      components

      03 COMPONENTS

      Innovative Approach: Five Core Components

      We deliver value to every client with advanced insight and expertise in various areas that combine with our core components to provide transparent, customized and flexible PBM solutions with market-leading pricing.

      Our innovative and vendor-agnostic approach allows us to deliver exceptional pharmacy benefits solutions with a true hands-on management approach that ensures we match clients with the services they need.

      • RFP Services
      • Coalition Contracts
      • Specialty Drug Management
      • Stop-Loss Coverage
      • Data Analytics

      Cost-Saving RFP Services

      We make it easy to choose the pharmacy benefits services and solutions you want in your contract with expert RFP services and consulting. With industry expertise, we provide guidance to help create the perfect integrated proposal.

      • Contract Review
      • Contract Pricing Validation
      • Clinical Evaluation & Recommendations
      • Rebate Procurement

      Clear & Competitive Coalition Contracts

      We leverage our purchasing power to deliver coalition-level PBM contracts with 100% transparency. Each agreement is customized and optimized to provide value, ongoing savings, and clinical insight to improve performance.

      • Market-Leading Discounts & Rebates
      • 100% Transparency
      • Free of Optics & Games

      Specialty Drug Management

      We offer proactive pharmacy consulting with specialty drug management and cost-containment solutions to achieve the lowest Rx prices and reduce costs on otherwise expensive health-related treatments.

      • Specialty Management Programs
      • Strong Clinical Programs: (PA, UM, Step Therapy, QL, Split Fill)
      • Patient Engagement & Coaching
      • Copay Card/Accumulator Programs

      Experienced Stop-Loss Coverage

      With over 30 years of experience in PBM and stop-loss, we can help clients plan for and avoid high costs from prescription drugs. We’ll make sure plans provide protection and cost savings.

      • Competitive Rx-Only Stop-Loss Protection
      • Plan Design Recommendations
      • ERISA Consultation
      • Medical Channel Management

      Expert Predictive Analytics Solutions

      With predictive data analytics, we improve plan performance, measure KPIs and find clinical opportunities to identify and improve cost containment. We also offer trend management and forecasting.

      • Drug Class and Therapy Management
      • Predictive Modeling & Analytics
      • Retail Network and Formulary Disruption
      • High-Cost Drug and PA Reviews

      components

      expertise

      04 expertise

      Specialized Areas of Focus & Expertise

      To provide flexible and innovative solutions that meet clients’ unique needs, we have diverse expertise in a range of focus areas. Combined with our core PBM services, these additional areas of expertise allow us to customize plans, drive competitive pricing and increase contract coverage with advanced solutions for cost savings as needed.

      Advanced PBM Solutions & Services

      • Pricing & Contract Procurement
      • Clinical Management
      • Contact Pricing Validation
      • Trend Management
      • Drug Pipeline Reporting
      • Peer Benchmarking
      • Specialty & Orphan Drug Management
      • Gene Therapy
      • Pharmacogenomics
      • Formulary Management
      • Cost Containment
      • MAC Management
      • PBM Vendor Management
      • White-Glove Account Management

      05 Case studies

      Controlling Costs at Renewal

      Situation: Our broker partner had successfully built a block of business by transitioning clients to a self-funded platform; however, the group was having difficulty managing claims and started to experience significant increases in their medical stop-loss premium at renewal, making self-funding unstable for these groups.

      Partnership: Crumdale Partners worked alongside the broker to understand the current suite of vendors serving the group of accounts to identify improvements that could be implemented.

      Results: Franklin Health successfully stabilized costs, offered transparency and flexibility to the block, and significantly reduced spending over the next year through a market-leading PBM contract, Rx cost-containment solutions and active medical and Rx claims monitoring and management.

      $1.7M +

      Increased surplus retained from $0 to $1.7 million in one year

      47%

      Reduced claims spend by 47% over one year

      $350k +

      Saved more than $350,000 in claims through med & Rx intervention

      $200k+

      Annual Savings of $226,705

      28.3%

      1st-Year Savings

      $350k +

      Achieved $351,485 in Rebates

      Advanced Clinical Insight

      Situation: A pharmacy analysis was performed for a California employer receiving pharmacy benefits bundled through their medical carrier.​ The incumbent program lacked accountability with no contract guarantees, limited insight on Rx claim utilization and restricted payment validation.​

      Partnership: Crumdale Partners worked alongside the broker to understand the current PBM solution and contract to provide a program with transparency and accountability.

      Results: ​The newly proposed PBM program from TRx offered a signature-ready contract and proposal that would immediately yield significant savings based on current member utilization while improving the overall employer experience and resulting in minimal member disruption.​

      results

      Specialty Cost Containment
      Case Studies

      06 case results

      Average Plan Savings: 61.1%*

      CLIENT Plan cost without program PMPM Without program Plan Cost With program PMPM With program Savings ($) Savings (%) PMPM Savings ($)
      #1:
      238 Lives
      $ 377,469 $ 132.17 $ 178,743 $ 62.58 $ 198,726 52.6% $ 69.58
      #2:
      237 Lives
      $ 278,048 $ 97.77 $ 170,016 $ 59.78 $ 108,033 38.9% $ 37.99
      #3:
      46 Lives
      $ 209,232 $ 379.04 $ 13,947 $ 25.27 $ 195,285 93.3% $ 353.78
      * Based on average for the identified sample set. Actual results may vary.

      Delivering Client Value:
      Case Studies Across Industries

      COMPANY Law Firm Tech Labor County City
      LIVES 111 1,008 2,456 7,140 13,491
      YEAR 1 SAVINGS ($) $ 10,555 $ 123,347 $ 352,621 $ 3,671,551 $ 5,145,422
      YEAR 1 SAVINGS (%) 32.0% 20.7% 12.5% $ 3,671,551 24.1%

      Continued Support
      Even After Signing

      Our relationship doesn’t need to end when the contract closes. Let our health insurance experts provide ongoing HR support, benefit navigation, and education services, so employees get the most out of their insurance and benefits.

      09 how we care

      Crumdale Contact Form